There is now every chance George Pell will not return to Australia to face the Royal Commission into Institutional Responses to Child Sexual Abuse.

Suppressed medical certificates allowed him to delay giving testimony in December, and it looks likely a similar appeal will be made on his behalf next week.

It is an appalling thought for those who have gone through the hurt of testifying that the country’s most senior Catholic may never sit in the stand where they were heard. That he may never face them. That he may never feel the heat of their anguish.

But even if this satisfaction is never offered, already we know who is George Pell. We know his is a church of business, of power over faith. We know his is a church that cynically defends itself against those it has ruined. That punishes victims and protects paedophiles.

We know what George Pell told Anthony and Chrissie Foster when he arranged to meet them in the storage room of a Melbourne presbytery – them forced to sit on a slim wooden bench; him in a padded leather chair.

Two of the Fosters’ daughters had been raped multiple times by the same priest, Kevin O’Donnell. The church had known of his abuse for decades, and protected him. The parents showed pictures of one daughter’s self-harm, an expression of the pain that would later see her commit suicide. “Hmmm,” Pell said without expression. “She’s changed, hasn’t she?”

Their other daughter is in a wheelchair, having been hit by a car, drinking to numb the trauma of her abuse. Their story is beyond appalling, the church’s offer of compensation grimly tokenistic. “If you don’t like what we are doing,” Pell said at the meeting, “take us to court.”

Another of O’Donnell’s victims described meetings with Pell and members of the church as “unpleasant and distressing” and “harsh, cold and uncaring”.

Anthony Foster, in an earlier inquiry, said Pell showed a “sociopathic lack of empathy, typifying the attitude and response of the Catholic hierarchy”.

This is just one part. We know that, when told in 1974 by a 12-year-old that a fellow priest was abusing boys, Pell allegedly told the victim: “Don’t be ridiculous.” Pell denies this. The priest in question abused at least 20 children.

We know that, when David Ridsdale told Pell he had been abused by his uncle, the priest Gerald Ridsdale, Pell allegedly responded: “I want to know what it will take to keep you quiet.”

Pell denies this, too. Gerald Ridsdale abused at least 50 children. Pell accompanied him to court for an early appearance.

We know that, when he faced the commission by video link in 2014, Pell used a bizarre analogy to limit the church’s responsibility: “If the truck driver picks up some lady and then molests her, I don’t think it’s appropriate, because it is contrary to the policy, for the ownership, the leadership of that company, to be held responsible.”

We know that, when the commission was announced, Pell said: “We object to being described as the only cab on the rank.”

Pell seems bereft of the language to talk about pain. He seems unable to see it, certainly to feel it. On this issue he is without empathy.

Perhaps he cannot see the good that could be done from fronting the commission in person. Perhaps he does not understand the power of symbol in healing. Perhaps he does not understand healing at all.

Perhaps he knows, deep down, that nothing he says could possibly repair the endlessly cruel-hearted things that have already been said.

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